Publication

2019 Healthcare Compliance Benchmark Report

Richard P. Kusserow | May 2019

This report provides results from SAI Global’s tenth annual Healthcare Compliance Benchmark Survey. It is a collaborative effort with Strategic Management Services, LLC, a nationally recognized expert in compliance consulting services for the healthcare industry, with Richard Kusserow, former U.S. Department of Health and Human Services (DHHS) Inspector General leading the analysis of the results. A key survey objective was to gain a better understanding of the status and progress of compliance program development in the healthcare industry. Respondents were asked a variety of questions relating to the current state of healthcare compliance, including demographic data, resource levels, reporting relationships, compliance program operations, challenges, and priorities for 2019.

Findings, along with an analysis of the significance of results, are based upon input from 419 respondents. Almost half of the respondents were from hospitals. However, there was a growing number of respondents from other provider areas, likely a result of mandates going into effect for skilled nursing facilities and increased enforcement of physician groups, clinics, Ambulatory Surgery Centers, home health, and hospices.

Over the past ten years of the survey, there is clear evidence that the role of the Compliance Officer has continued to evolve and encompass more responsibilities, particularly with Health Insurance Portability and Accountability Act (HIPAA) privacy/security, internal audit, and risk management. Evidence also suggests that many compliance programs may not be fully developed or may not be able to evidence effectiveness.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC to assist health care organizations develop, implement and assess compliance programs. Mr. Kusserow has worked with health care organizations to conduct compliance program effectiveness evaluations, deliver advisory services, develop policies and procedures and deliver compliance and internal investigations training.